Pulmonary Medicine ISSN 1930-6741
Ramesh Kaul ,MD, MS, FCCP
Fiber optic flexible bronchoscopy( FOB) was introduced by Ikeda and prior to that Rigid Bronchoscopy was done to evaluate the trachea (wind Pipe) and large bronchi like lobar bronchi the physicians would look, clean the bronchial tubes spray them with anesthetic and take microscopic pieces with small forceps and send for testing.
The advancement of FOB was that trans-bronchial lung biopsy for Cancer, pneumonias with uncertain diagnosis and sending washings for testing opened a array of easy testing for non resolving lesions/infiltrates of the lungs.
Fiber optic flexible Bronchoscope by Olympus Company
The bronchoscopy for removing foreign bodies, mucus plugs, aspirated materials, tumors, polyps is gaining popularity.
I personally do bronchoscopy for lung masses nodules, atypical pneumonias, pneumonia with immuno-compromised status with atypical behavior, foreign body in airway, blood in sputum with mild or moderate hemoptysis, checking for failure to wean on ventilator patients, unexplained hypoxemia or low oxygen.
I do rigid bronchoscopy for laser or excision of main-stem occlusive lesions or opening of lobar bronchi lesions or controlling major bronchial bleedings.
I have used it for removing difficult foreign objects.
Rigid bronchoscopy is an extremely safe procedure in experienced hands.
Fiber optic flexible Bronchoscopy is safe even to do at bed side.
Risks are rarely nasal bleeding, drop in the oxygen saturation due to sedation and use of saline lavage, and pneumothorax or bronchial bleeding if biopsy is taken.
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